Clinical comparative study of off-pump and conventional on-pump coronary artery bypass grafting in over 75-year-old patients with coronary artery disease
CHEN Mingbao
TIAN Zhong
XU Haisu
XIE Yaxuan
XIAO Feng
YUAN Fukang
Abstract：Objective To explore the application efficacy of off-pump coronary artery bypass(OPCAB)grafting and on-pump coronary artery bypass(ONCAB)grafting in over 75-year-old patients with coronary heart disease(CHD).Methods A prospective cohort study was conducted on 240 consecutive patients undergoing CAB grafting in Department of Cardiac Surgery of Xuzhou Central Hospital from January 2020 to May 2025.According to different surgical methods,they were divided into OPCAB group(180 cases)and ONCAB group(60 cases).The baseline characteristics before surgery and intraoperative and postoperative indicators were compared between the two groups.Results The OPCAB group had significantly shorter operation time(210.83±43.72 min vs 274.52±41.61 min)and activated clotting time(300.12±20.31 s vs 480.22±25.34 s),and less intraoperative blood loss(300.03±100.04 mL vs 450.03±120.02 mL)and blood transfusion volume(100.02±50.02 mL vs 200.04±60.03 mL)while obviously faster bridging blood flow and higher myocardial temperature when compared with the ONCAB group(P＜0.01).The OPCAB group also exhibited significantly shorter mechanical ventilation time and length of intensive care stay,lower troponin I and creatine kinase isoenzyme levels,and lower ratios of poor chest incision healing,acute kidney injury,low cardiac output syndrome,intra-aortic balloon counterpulsation,secondary thoracotomy hemostasis,re-intubation,and renal failure when compared with the ONCAB group(P＜0.05,P＜0.01).Conclusion OPCAB has significant advantages in reducing postoperative complications,accelerating recovery,alleviating myocardial injury,and improving quality of life,especially for over 75-year-old and high-risk patients.
Keywords：coronary heart diseaseperioperative managementpostoperative complicationsquality of life
Publication Date：2025-12-15
Online Publishing Date：2025-12-29(First online date of this platform, not the publication date of the document)
Pages：5( 1669-1673 )